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[DO NOT PUBLISH]

IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
________________________
No. 13-12414
Non-Argument Calendar
________________________
D.C. Docket No. 8:12-cv-00035-EAK-TBM

NATHANIAL STONE,
Plaintiff-Appellant,
versus
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.
________________________
Appeal from the United States District Court
for the Middle District of Florida
________________________
(September 26, 2014)
Before HULL, MARCUS, and FAY, Circuit Judges.
PER CURIAM:

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Nathanial Stone 1 appeals the district judges order affirming the Social
Security Administrations denial of his application for supplemental security
income (SSI). We affirm.
I. BACKGROUND
In 2009, Stone filed an application for SSI under Title XVI of the Social
Security Act (Act). His application was denied. Stone requested and was
granted an administrative hearing before an administrative law judge (ALJ). The
Notice of Hearing sent to Stone included two pages devoted to claimants rights to
representation by an attorney or other qualified person in Social Security
proceedings.
During the March 2011 hearing, Stone stated he understood his right to
representation and agreed to proceed without a representative. Stone further stated
he was not receiving medical treatment for any condition, and he identified no
physical problems. Stone testified he was 22 years old, had completed the eleventh
grade, and did not have a General Educational Development (GED) credential.
He lived with his parents, who supported him, and his two brothers. He had never
lived by himself. On a typical day, Stone watched television, listened to music,
and drew. Stone testified he previously had worked as a dishwasher for one or two

Stones first name is also spelled Nathaniel in the record.

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months. He also had worked as a housekeeper in 2009 for approximately one

month. The ALJ found Stone had no past relevant work.
When asked what medical conditions prevented him from working, Stone
responded he had difficulty understanding tasks assigned to him. He did some
housework, including sweeping, and he also raked the yard and did his own
laundry. He did not cook, and he never had tried to obtain a drivers license. He
shopped for groceries approximately once per month. He used to go to church, but
had not done so recently, and he visited with others from time to time.
Stones mother, Antoinette Stone, testified Stone had been born with a
cocaine dependency and had only one kidney. She did not identify any current
kidney problems. Antoinette Stone said Stone had a very short attention span,
which one school had identified as attention deficit disorder (ADD) and another
had identified as specific learning disability (SLD). Antoinette Stone testified
Stone previously had received SSI benefits until he reached age 18. She explained
Stone had failed to file timely the paperwork needed to continue his benefits
beyond age 18. Stone had been socially promoted to the eleventh grade with no
grade point average (GPA), and school personnel believed he was
unemployable. ROA at 69. Stone had done well in elementary and middle
schools, but when he reached the ninth grade, it appear[ed] that everything just
shut down. ROA at 69. When Stone was in the eleventh grade, Antoinette Stone
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learned he knew no more than he had in the ninth grade. School personnel told her
they could not help him. Antoinette Stone testified Stone had worked as a
dishwasher for approximately three months, until he had been terminated. At
home, Stone raked the yard, took out the garbage, vacuumed, and occasionally
raked others yards for pay.
The ALJ asked a vocational expert (VE) whether jobs existed in
significant numbers in the national economy that Stone could perform, assuming
Stone had no exertional limitations, was limited to unskilled work, and was a
younger aged individual with a limited education and no past relevant work.
ROA at 73. The VE identified the following jobs: farm worker or helper, office or
hotel cleaner, dishwasher, and maybe some kitchen helper type work. ROA at
74. None of those jobs required literacy. The ALJ asked whether jobs existed that
could be performed by a claimant with a severe mental impairment, who could not
concentrate or attend to basic job tasks. The VE identified no jobs. When given
the opportunity, neither Stone nor Antoinette Stone asked the VE any questions.
Stone also submitted several documents supporting his application. In 1996,
while Stone was in the first grade, school psychologist, Vicki Mayes, prepared a
Psychological and Learning Analysis Report. Stone had been referred for an
evaluation because of academic difficulties. Mayes reported Stones overall
cognitive ability was in the average range, in the thirty-fifth percentile for his age.
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Stones short-term memory was strong, but he had significant difficulties in

abstract visual analysis and synthesis, and a cognitive deficit in auditory
processing. Mayes noted significant ability/achievement discrepancies . . . in the
areas of Broad Reading, Basic Reading Skills and Reading Comprehension. ROA
at 218. Stones other skills and abilities were within the expected range for the
general intellectual development. ROA at 218.
An Exceptional Student Education Department Individual Educational Plan
(IEP) was prepared in 2006, while Stone was in the tenth grade. The IEP
identified Stones Primary Exceptionality as Specific Learning Disabilities.
ROA at 207. The IEP reported Stone was functioning at a sixth-grade level in
reading and math, had a GPA of 1.0, and lacked employability skills. Effective
August 2006, he had been reassigned to a special diploma option. ROA at 207.
According to the IEP, Stone did not currently express himself in the academic
setting, and did not communicate effectively in group settings. ROA at 208.
Due to lack of consistent attendance, he was incapable of maintaining passin[g]
grades in the general education setting. ROA at 209. The IEP provided for
several accommodations, including (1) repeating, clarifying, or summarizing
instructions; (2) providing verbal encouragement; and (3) providing cues to
maintain attention to tasks. A Disability Report that appears to have been
completed by Stone or on his behalf in 2009 asked: Why did you stop working?
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ROA at 143. The response stated: Over[-]slept. Did not get up and go to work.
ROA at 143.
In July 2009, consultative examiner Linda Appenfeldt, Ph.D., performed an
evaluation of Stone. Dr. Appenfeldt reported Stone had [a] poverty of speech
and was slow in his presentation and interactions. ROA at 221. Dr. Appenfeldt
detected a faint smile when Stone gave incorrect answers, such as when he
said a bird has four legs. ROA at 221. Stone, however, correctly identified the
current United States president. Dr. Appenfeldt reported intelligence quotient
(IQ) scores, based on the Wechsler Adult Intelligence Scale, fourth edition:
(1) verbal comprehension: 50; (2) perceptual reasoning: 50; (3) working memory:
50; (4) processing speed: 50; and (5) full-scale IQ: 41. All scores were in the first
percentile, and Stones full-scale IQ score was in the extremely low range of
intelligence. Dr. Appenfeldt stated the results should be used with caution, as
they are believed to significantly underestimate [Stone]s true abilities and
[Dr. Appenfeldt] question[ed] the reliability and validity of the scores. ROA at
223. Dr. Appenfeldt assigned Stone a Global Assessment of Functioning
(GAF) 2 score of 50. Dr. Appenfeldt stated she was not convinced of the
2

The GAF is a 100-point scale divided into 10 numerical ranges, which permits
clinicians to assign a single-ranged score to a persons psychological, social, and occupational
functioning. Keyes-Zachary v. Astrue, 695 F.3d 1156, 1162 n.1 (10th Cir. 2012) (citing Am.
Psychiatric Assn, Diagnostic & Statistical Manual of Mental Disorders 32, 34 (Text Revision
4th ed. 2000)). GAF scores of 41 to 50 indicate serious symptoms (suicidal ideation, severe
obsessional rituals, or frequent shoplifting) or any serious impairment in social, occupational, or
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severity of [Stones] impairments, as he has presented them. There is the

consideration Nathaniel Stone is exaggerating and magnifying problems in order to
obtain financial compensation for himself with secondary gains operating. ROA
at 223.
In September 2009, state agency consultant Arthur Hamlin, Psy.D.,
completed a psychiatric review technique form (PRTF) for Stone. Dr. Hamlin
reported Stone suffered from the following, which Dr. Hamlin categorized as Not
Severe: (1) an Organic Mental Disorder[], which Dr. Hamlin described as
learning disability by history; and (2) a Personality Disorder[], which
Dr. Hamlin described as oppositional defiant disorder. ROA at 225-26, 232.
Addressing the paragraph B criteria listed in 20 C.F.R. Part 404, Subpart P,
Appendix 1 (the Listings), Dr. Hamlin explained Stone experienced no
restrictions in the activities of daily living; mild difficulties in maintaining social
functioning and concentration, persistence, or pace; and no extended episodes of
decompensation. Stone did not satisfy any of the criteria in paragraph C of the
Listings.

school functioning (having no friends or being unable to keep a job); scores of 51 to 60 indicate
moderate symptoms (flat affect and circumstantial speech or occasional panic attacks) or
moderate difficulty in social, occupational, or school functioning (having few friends or conflicts
with peers or coworkers). Id.
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In May 2010, state agency consultant Nancy Dinwoodie, M.D., also

completed a PRTF for Stone. Dr. Dinwoodie also reported Stone suffered from a
Not Severe Organic Mental Disorder[], which she described as a learning
disorder [not otherwise specified] with average intelligence. ROA at 239-40.
Addressing the paragraph B criteria of the Listings, Dr. Dinwoodie found Stone
experienced no restrictions in daily living activities or difficulties in maintaining
social functioning, concentration, persistence, or pace; and no extended episodes of
decompensation. Dr. Dinwoodie did not address the paragraph C criteria.
The ALJ concluded Stone had not been disabled under the Act, since he had
filed his application. The ALJ determined Stone had not engaged in substantial
gainful activity since the date of his application. He had two medically
determinable impairments: questionable learning disorder and oppositional traits.
Stone, however, did not have an impairment or combination of impairments that
significantly limited the ability to perform basic work-related activities for 12
consecutive months. Therefore, he did not have a severe impairment or
combination of impairments.
The ALJ noted Stones medically determinable impairments reasonably
could be expected to produce some of the alleged symptoms, but Stones
statements concerning the intensity, persistence, and limiting effects of those
symptoms were not credible. The ALJ discussed the reports prepared by Mayes in
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1996, and by Dr. Appenfeldt in 2009. The ALJ also reported Stone had been very
unresponsive during his hearing, and determined the activities reported by Stone
and his mother did not support a finding of total disability. ROA at 51. Stones
employment had been terminated in June 2009, because he had overslept and did
not go to work, and not because of cognitive issues. Stone also had no severe
physical impairments.
The ALJ gave great weight to Dr. Appenfeldts opinion, which the ALJ
found to be consistent with Stones performance during his consultative
examination, Mayess 1996 report, Stones reported activities, and Stones
unresponsiveness during his hearing. The ALJ acknowledged Dr. Appenfeldt had
assigned Stone a GAF score of 50, but also noted Dr. Appenfeldt had not been
convinced of the severity of Stones impairments as he presented them and
believed Stone may have been exaggerating his problems. The ALJ gave great
weight to the state agency consultants assessments, which the ALJ found to be
consistent with the record as a whole. Regarding the paragraph B criteria of the
Listings, the ALJ concluded Stone had (1) no restrictions in daily-living activities;
(2) no more than mild limitations in social functioning, concentration, persistence,
or pace; and (3) no extended-duration episodes of decompensation. Consequently,
Stones medically determinable mental impairments were non-severe, under 20

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C.F.R. 416.920a(d)(1). The Appeals Council denied Stones counseled request

for review.
In district court, Stone filed a memorandum in which he argued the record
showed he had a severe impairment and lacked employability skills. A magistrate
judge issued a report and recommendation (R&R), recommending the ALJs
decision be affirmed. The magistrate judge concluded nothing in the record
showed Stone suffered from an intellectual disability 3 or borderline intellectual
functioning. The magistrate judge concluded the ALJ fairly addressed the record
evidence and substantial evidence supported the ALJs determination, because
Stones IQ score was considered invalid, and there was no indication his GAF
score signified an inability to work. In his objections to the R&R, Stone argued his
IQ score of 41 was valid and accurate and there is nothing in the record to detract
from such score. ROA at 353.
The district judge overruled Stones objections, adopted the R&R, and
affirmed the denial of Stones request for SSI. The judge concluded Stone
knowingly had waived his right to representation during his hearing and the ALJs
duty to develop the record did not rise to the level of a special duty. ROA at
360. Stone had the opportunity to obtain and present additional records, but failed
3

A rule adopted on August 1, 2013, replaced the term mental retardation with
intellectual disability in the Listings. See 78 Fed. Reg. 46,499, 46,501-02 (Aug. 1, 2013).
Consequently, the terms intellectual disability and intellectual-disability listing are used in
this opinion.
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to do so. Stone did not meet the intellectual-disability listing, because the record
did not show adaptive deficits; once the VE testified an individual with Stones
limitations could find jobs in the national economy, the burden shifted back to
Stone to show he could not perform those jobs.
On appeal, Stone argues the ALJs hypothetical improperly failed to include
Stones difficulties with concentration. He asserts his school records, which show
he has difficulty reading and lacks employability skills, are sufficient to establish a
severe mental impairment. When combined with his limited reading and math
abilities, his inability to graduate from high school, and the finding that he is
unemployable, this impairment, Stone argues, shows he cannot sustain any form of
work under Social Security Ruling (SSR) 96-8p, 1996 SSR LEXIS 5 (July 2,
1996). Stone contends the fact he gave one questionable answer during
Dr. Appenfeldts examination should not call into question his IQ score. He argues
the ALJ had a special duty to protect him and develop the evidence for and
against him, because he was unrepresented. Appellants Br. at 16. Stone contends
the ALJ improperly gave significant weight to the opinions of non-examining state
agency doctors and erroneously determined Stone did not satisfy the fourth step of
the sequential analysis. He also asserts the ALJ ignored his prior benefits award
and GAF score.

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II. DISCUSSION
We review the Commissioners decision for substantial evidence. Winschel
v. Commr of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011). Substantial
evidence is more than a scintilla and is such relevant evidence as a reasonable
person would accept as adequate to support a conclusion. Id. (citation and internal
quotation marks omitted). We may not decide the facts anew, reweigh the
evidence, or substitute our judgment for that of the Commissioner. Id. Even if the
evidence preponderates against the Commissioners factual findings, we must
affirm if the decision reached is supported by substantial evidence. Moore v.
Barnhart, 405 F.3d 1208, 1213 (11th Cir. 2005) (per curiam).
The ALJ must state specifically the weight accorded to each item of
evidence and why a decision was reached. Hudson v. Heckler, 755 F.2d 781, 786
(11th Cir. 1985) (per curiam). Similarly, the ALJ must state with particularity the
weight given to different medical opinions and the reasons for them. Winschel,
631 F.3d at 1179. Generally, a treating doctors opinion is entitled to more weight
than that of a consulting doctor. Spencer ex rel. Spencer v. Heckler, 765 F.2d
1090, 1093-94 (11th Cir. 1985) (per curiam). Reports of non-examining
physicians, taken alone, do not constitute substantial evidence. Id. at 1094.
Nevertheless, an ALJ may rely on opinions of non-examining sources when they

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do not conflict with those of examining sources. See Edwards v. Sullivan, 937
F.2d 580, 584-85 (11th Cir. 1991).
The Commissioner uses a five-step, sequential evaluation process to
determine whether a claimant is disabled for purposes of eligibility for SSI. 20
C.F.R. 416.920(a)(4); Crayton v. Callahan, 120 F.3d 1217, 1219 (11th Cir.
1997). The first three steps ask whether the claimant (1) currently is engaged in
substantial gainful activity and (2) has a severe impairment or combination of
impairments (3) that meets or equals the severity of the specified impairments in
the Listings. 20 C.F.R. 416.920(a)(4)(i)-(iii); Crayton, 120 F.3d at 1219. The
fourth step asks whether, based on a claimants residual functional capacity
(RFC) assessment, the claimant can perform any of his past relevant work. 20
C.F.R. 416.920(a)(4)(iv); Crayton, 120 F.3d at 1219. The final step asks whether
there are significant numbers of jobs in the national economy the claimant can
perform, given his RFC, age, education, and work experience. 20 C.F.R.
416.920(a)(4)(v); Crayton, 120 F.3d at 1219.
An impairment or combination of impairments is severe if it significantly
limits the claimants physical or mental abilities to perform basic work activities.
20 C.F.R. 416.920(c), 416.921(a); Crayton, 120 F.3d at 1219. Basic work
activities include understanding, carrying out, and remembering simple
instructions; use of judgment; responding appropriately to supervision, co-workers
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and usual work situations; and dealing with changes in a routine work setting. 20
C.F.R. 416.921(b)(3)-(6).
The claimant bears the burden of proving he has a severe impairment or
combination of impairments. See McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th
Cir. 1986). If the claimant does not have a severe impairment or combination of
impairments, he is not disabled. Id. (citing 20 C.F.R. 416.920(c)). An
impairment or combination of impairments is not severe if it is a slight abnormality
or a combination of slight abnormalities that would have no more than a minimal
effect on the claimants physical or mental abilities to work, irrespective of age,
education, or work experience. See Bridges v. Bowen, 815 F.2d 622, 625-26 (11th
Cir. 1987) (per curiam). A claimant need show only that his impairment is not so
slight, and its effect is not so minimal. McDaniel, 800 F.2d at 1031. The
claimants burden at step two is mild, since this inquiry allows only claims based
on the most trivial impairments to be rejected. Id.
The mental-disorders listings generally contain (1) an introductory
paragraph describing the disorder(s) addressed by the listing; (2) a set of medical
findings, referred to as the paragraph A criteria; (3) a set of impairment-related
functional limitations, referred to as the paragraph B criteria; and, in some cases,
(4) additional functional criteria, referred to as the paragraph C criteria. See 20
C.F.R. pt. 404, subpt. P, app. 1, 12.00(A). For an impairment to meet one of
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these listings, it must satisfy both the diagnostic description in the introductory
paragraph and the criteria for both paragraphs A and B, or A and C, when
appropriate. Id.
Severity is measured according to the functional limitations imposed by
[ones] medically determinable mental impairment(s). Id. pt. 404, subpt. P, app.
1, 12.00(C). Functional limitations are assessed using the four paragraph B
criteria: activities of daily living; social functioning; concentration, persistence, or
pace; and episodes of decompensation. Id.; see also id. 416.920a(c)(3). A
mental impairment generally is considered non-severe under step two if the degree
of limitation in the first three paragraph B criteria is rated as none or mild and
there have been no episodes of decompensation. Id. 416.920a(d)(1).
The ALJ has a basic obligation to develop a full and fair record. Cowart v.
Schweiker, 662 F.2d 731, 735 (11th Cir. 1981). Where a claimant has not waived
his statutory right to counsel, this obligation rises to a special duty when an
unrepresented claimant unfamiliar with hearing procedures appears before the
ALJ. Id. (citation and internal quotation marks omitted).
Because Stone waived his right to representation during his hearing, his
argument that the ALJ owed him a special duty to develop the evidence for and
against him is misplaced. See id. Substantial evidence supports the ALJs steptwo finding that Stone did not meet his burden of showing he had a severe
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impairment under the Act. See 20 C.F.R. 416.920(a)(4)(ii), (c), 416.920a(d)(1),

416.921(a)-(b); Winschel, 631 F.3d at 1178; Crayton, 120 F.3d at 1219; McDaniel,
800 F.2d at 1030. Specifically, the ALJ determined Stone had no more than mild
restrictions in daily-living activities, social functioning, and concentration,
persistence, or pace, and that he had no extended-duration episodes of
decompensation. These determinations were supported by (1) the report of
Dr. Appenfeldt, who opined Stone may have been exaggerating his problems;
(2) the reports of Dr. Hamlin and Dr. Dinwoodie, both of whom indicated Stones
impairments were not severe, and that Stone experienced no more than mild
restrictions in daily-living activities, social functioning, and concentration,
persistence, or pace, and had no extended-duration episodes of decompensation;
(3) the testimony of Stone and his mother, who reported Stone previously had
worked as a dishwasher and housekeeper, engaged in housework, raked yards, did
his own laundry, and shopped for groceries; (4) evidence that Stone lost a prior job
because he had overslept and did not go to work, and not because of cognitive
issues; and (5) the ALJs finding Stones statements concerning the intensity,
persistence, and limiting effects of his symptoms were not credible to the extent
they were inconsistent with the finding that he had no severe impairment or
combination of impairments. The ALJ was entitled to discount Stones IQ and
GAF scores based on Dr. Appenfeldts opinion that the scores significantly
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underestimate[d] Stones abilities, and that Stone may have been exaggerating his
impairments intentionally. ROA at 223.
The record does not support Stones suggestion that Dr. Appenfeldt called
into question the validity of his test scores based on only one questionable answer
during his exam. Dr. Appenfeldts report explicitly stated she detected a faint
smile by Stone, when he gave multiple incorrect answers. Dr. Appenfeldt also
concluded Stone was exaggerating and magnifying multiple problems. Read in
context, Dr. Appenfeldt reported Stones statement that a bird has four legs as only
one example of his questionable answers. Stone also has not shown the ALJ gave
improper weight to the state agency consultants opinions, which the ALJ found to
be consistent with the record as a whole. See Edwards, 937 F.2d at 584-85.
Stones citation to SSR 96-8p is misplaced. This Policy Interpretation
Ruling addresses the step-four and step-five RFC assessments; therefore, it has no
relevance to the ALJs step-two determination that Stone did not have a severe
impairment or combination of impairments. See SSR 96-8p, 1996 SSR LEXIS 5 at
*8 (RFC is an issue only at steps 4 and 5 of the sequential evaluation process.).
Stones arguments regarding the step-four inquiry likewise are misplaced.
Notwithstanding the ALJs hypothetical question including a severe mental
impairment, the ALJs ultimate denial of benefits was based on a step-two finding
that Stone had not shown a severe impairment or combination of impairments.
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Although it would have been prudent for the ALJ to have addressed Stones prior
award of benefits as a child, see Hudson, 755 F.2d at 786; Cowart, 662 F.2d at
735, Stone has advanced no argument on appeal concerning the extent to which, if
any, his receipt of benefits as a child may be relevant to his application for benefits
as an adult. See Timson v. Sampson, 518 F.3d 870, 874 (11th Cir. 2008) (per
curiam) (explaining a litigant who offers no substantive argument on an issue in his
initial brief abandons that issue on appeal); cf. 20 C.F.R. 416.987(a) (explaining
eligibility for SSI benefits must be redetermined when a claimant reaches age 18,
and that an adult claimant may be found to be not disabled, despite having been
eligible for SSI benefits as a child).
AFFIRMED.

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